Rural patients find success with the help of telehealth lactation services through Intermountain Health
Chelsea Breur knew she wanted to breastfeed her third child.
“I had successfully breastfed my first two kids and knew all the benefits of breastfeeding. But after Henry was born at Intermountain Fillmore Community Hospital, I couldn’t get him to latch on properly. It was surprising that I couldn’t get breastfeeding to work, since I’d done it before,” said Breur, who lives in Meadow, Utah.
Breur, who works as a social media director specializing in sports partnerships and is a runner herself, was determined to make breastfeeding work. And in the end, it took a team of people to help Chelsea and Henry succeed.
Intermountain Fillmore Community Hospital is an 18-bed critical access hospital in central Utah. The hospital has 20 nurses on staff and like most rural hospitals, their nurses are cross-trained to fill a variety of roles, everything from the emergency room to labor and delivery, to caring for sick or injured patients admitted to the hospital.
When Shelby Bullock, BSN became the women and newborn nurse manager at Fillmore Community Hospital about two and a half years ago, she wanted to help more new moms succeed at breastfeeding while they were in the hospital after childbirth. She and other nurses were working on a goal to help the hospital earn a five-star breastfeeding rating from the Utah Department of Health’s Stepping Up for Utah Babies program.
“Though many moms in the hospital initially started breastfeeding in the hospital, they didn’t always continue breastfeeding during their stay. Like some other rural hospitals, we had nurses trained to help with breastfeeding, but we didn’t have a certified lactation consultant on staff,” said Bullock.
Bullock found a creative way to help the hospital’s nurses learn more about best breastfeeding practices, so they could teach their patients. She set up provider-to-provider telehealth consultations, so a certified lactation consultant at Intermountain Orem Community Hospital could consult remotely with a Fillmore Hospital nurse who worked in labor and delivery, and the patient who wanted to breastfeed.
“Before we were using telehealth lactation consultations, our breastfeeding rate for moms who breastfeed in the hospital was just 26 percent. About two years and many telehealth consultations later, the breastfeeding rate is now 88 percent. When you serve a small number of patients, every patient makes a big difference in our success rate,” said Bullock.
“Through telehealth our nurses have remote access to lactation consultants that provide them with additional training and tips, so they can help news moms solve common breastfeeding challenges – like how to hold and position the baby – and the more unique breastfeeding challenges,” said Bullock.
“The lactation consultant offers suggestions through telehealth and the nurse at the bedside provides the hands-on help and further encouragement needed, to teach women the skills they need to breastfeed successfully, added Bullock.
“Thanks to support from a nurse at Fillmore Hospital and a telehealth visit from a lactation consultant at Orem Community Hospital, I learned my baby was tongue tied, and needed a simple surgical procedure to have it clipped, so he’d be able to breastfeed well,” said Breur.
According to La Leche League, a tongue-tie is an unusually short, thick, or tight band of tissue that tethers the bottom of the tongue to the floor of the mouth, inhibiting a full range of motion. And it may make breastfeeding more difficult.
Breur felt the staff at Fillmore Hospital really cared and knew her personally. After leaving the hospital, she needed additional support from a community-based lactation consultant, and was able to have an oral surgeon fix her son’s tongue-tie when he was about three months old.
The ten steps of the Stepping Up for Utah Babies program are evidence-based maternity care practices that demonstrate optimal support of breastfeeding, as well as improved care experiences and outcomes for non-breastfeeding moms and families.
They include hospital practices such as: encouraging moms to hold their new baby skin-to-skin right after delivery; allowing moms and babies to remain together 24 hours a day in the hospital; training staff to support all new moms’ feeding choices; encouraging breastfeeding on demand; reducing formula supplementation unless medically indicated; and not using pacifiers for breastfeeding infants.
All Intermountain Hospitals in Utah have earned or are working toward the five-star breastfeeding friendly rating.
The state health program website cites research that shows breast milk is the best food for infants and that breastfeeding is associated with decreased risk for infant morbidity and mortality. It’s also been shown that breastfeeding moms have lower incidences of breast and ovarian cancer, Type 2 diabetes and postpartum depression.
The state program is patterned after the international Baby Friendly Hospital Initiative started by the World Health Organization and the United Nations Children’s Fund in the 1990s.
Intermountain Health offers a variety of virtual and in-person resources for moms who choose to breastfeed Intermountainhealth.org has a virtual breastfeeding class available for expectant parents. It’s a one session, two-hour class and offered often.
Or go to the Intermountain Parents Facebook page for videos that answer breastfeeding questions and provide breastfeeding tips. For a free complete guide to breastfeeding booklet and a list of local outpatient lactation consultant services, contact a nearby Intermountain hospital or visit intermountainhealth.org.
About Intermountain Health
Headquartered in Utah with locations in seven states and additional operations across the western U.S., www.intermountainhealth.org is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 3,900 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information or updates, see https://intermountainhealthcare.org/news.